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Prevention of postnatal growth restriction by the implementation of an evidence-based premature infant feeding bundle

P D Graziano1, K A Tauber2, J Cummings2

  • 1Nursing (Neonatology), Albany Medical Center, Albany, NY, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 17, 2015
PubMed

Insights

A new feeding bundle for very low birth weight (VLBW) infants significantly reduced post-natal growth restriction (PNGR) and improved head growth. This evidence-based approach enhanced infant outcomes safely and effectively.

Area of Science:

  • Neonatal Nutrition
  • Pediatric Growth Monitoring
  • Evidence-Based Medicine

Background:

  • Post-natal growth restriction (PNGR) is a significant concern in very low birth weight (VLBW) infants.
  • Optimizing feeding strategies is crucial for improving growth trajectories and long-term outcomes in VLBW neonates.

Purpose of the Study:

  • To develop and implement an evidence-based feeding bundle to reduce PNGR in VLBW infants.
  • To evaluate the safety and efficacy of the feeding bundle on infant growth and feeding milestones.

Main Methods:

  • A standardized feeding bundle was developed and implemented in January 2010.
  • Infant outcomes, including days to first feed (FD), days to reach full feeds (FF), and growth trajectories (delta z-score) for weight and head circumference (HC), were monitored for 3 years.
  • Data from 482 VLBW infants (119 pre-bundle) were analyzed.

Main Results:

  • The incidence of PNGR decreased significantly from 35% to 19% (P<0.01) post-implementation.
  • Weight delta z-score improved from -0.82 to -0.45 (P<0.001), and HC delta z-score improved from -0.65 to -0.17 (P<0.001).
  • Significant reductions in FD and FF were observed, with downward trends in necrotizing enterocolitis and markers of cholestasis.

Conclusions:

  • The evidence-based feeding bundle is a safe and effective intervention for reducing PNGR in VLBW infants.
  • Implementation of the bundle led to improved head growth and overall growth trajectories in this vulnerable population.
  • Standardized feeding protocols can positively impact key neonatal outcomes.
Abstract

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